Mitral Valve Problems...

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bassadict69

This is about my dad who is currently in a long term care hospital with a major fluid retention problem, mainly in his belly area. His first problem was early this year with some sores on his lower legs. The sores were diagnosed as venous ulcers caused by a problem with the valves in the veins of his lower body ( I forget the name of it now) 8 months later, they are healing nicely but far from being completely healed.
A little over a week ago, his abdomen had become distended BIG TIME! We carried him to the ER where they admitted him in & started him on large doses of Lasix to help remove the fluid. They also did an echo of his heart & we got the results back yesterday. I was not there but from what my dad said, the doc told him his Mitral valve is not closing & that it was probably the source of ALL his problems recently. The plan is to keep him in the long term care hospital for about 3 weeks or long enough to remove all the excess fluid, then refer him directly to a heart specialist ASAP.

Can this open Mitral valve be the cause of all his problems this year? What can we expect to happen once he starts seeing the specialist?

By the way, a few years ago he was diagnosed with CHF but there was no mention of a valve problem.
 
Your dad may have several medical issues going on concurrently.

Here's something about the valves in leg veins from the online Merck's manual and the Cleveland Clinic's website:

http://www.merck.com/mmhe/sec03/ch036/ch036a.html

http://my.clevelandclinic.org/disorders/venous_disease/vs_overview.aspx

If a heart valve isn't working properly, you can get CHF. My father-in-law did before his 2nd MVR surgery -- spent about 2 weeks in the hospital on diuretics before they could operate -- and they gave me diuretics the day before my MVR, due to fluid buildup.
 
Umm, yup, could be the source indeed. The valve not closing can lead to CHF and fluid retention in the body, frequently in the legs, belly and lungs (that's why they call it "congestive" heart failure). Been there, done that, got the scars to prove it.

The excess fluid in the legs could certainly logically put strain on the valves in the leg veins, leading to the ulcers. Lord knows the excess fluid in the legs HURTS sometimes.

Sounds like a good course of action, and perhaps a smart doctor.
 
It sounds like he needs a thorough Cardiovascular checkup, starting with an EchoCardiogram (simple non-invasive echo of the heart, similar to a sonogram of a pregnant mother to be).

Yes, Regurgitation (also called Insufficiency) can cause excessive fluid buildup and CHF.

Mitral Valves can be repaired (if caught early enough) or replaced. Valve Replacement is Major Surgery but is a highly refined art with Very High Success Rates (98% for first timers under age 60). NOT repairing or replacing a defective valve is an invitation to an early demise.

Get him checked out by a good Cardiologist ASAP.

'AL Capshaw'
 
Make sure that whomever is treating him walks that fine line of removing the fulid without doing damage to his kidneys. My mom had CHF and everytime she ended up in the hospital due to fluid retention her doctor's had to monitor her very closely. Ask lots of questions of his doctor's including a kidney specialist if he has one. God Bless You and Your Family...
 
Yes, valve problems can cause CHF. So once he has his cardiology workup, then it will be clear (I hope) what direction his treatment will take.

To ease your mind a little, my husband had very severe CHF which had to be watched like a hawk. It is something that can be controlled with medication and a low sodium diet, and the care of en excellent cardiologist.

There are all kinds of diuretics that can be used to get rid of fluid, some in pill form, and some in IV form.

So, even the most difficult fluid retention situation can be taken care of as long as the kidneys cooperate.

If your dad listens to his cardiologist and does exactly as he's told to do regarding monitoring his fluid retention at home, and keeping to a low sodium diet and taking his meds as directed, he can do well, and keep the devil at bay for a long, long time.

Welcome to the site.
 
Why are they even waiting to get a cardiologist on board? Seems to me he should be involved now and making things ready for the next step.
 
Ross said:
Why are they even waiting to get a cardiologist on board? Seems to me he should be involved now and making things ready for the next step.
Click to expand...

That is pretty much my thinking...I know is he only in a long term care hospital, but I do not see why the cardio couldn't go to him to get started on whatever tests need to be done or whatever.

I also would not see a problem with one of us picking him up & carrying him to the cardio's office for a few visits. At least if they get started now, once the fluid is completely off him, they would be ready to try to fix the problem.
 
Looks like dad will be in the long term care hospital until the 13th of this month. They are now giving him lower doses of Lasix (by mouth now) & have removed his catheter. He looks alot better & you can tell he has lost alot of weight with all the fluid that has come off him. He still uses a walker & gets winded fairly easily but is getting around ALOT better & easier on his own. He actually got mad the other day because therapy did not come take him for a walk around the hospital, so I look at that as a good sign that he is feeling well enough to at least want to get a little exercise!

According to his doc, he will probably have a week or so at home before his first appointment with the cardio & according to this doctor, he thinks the cardio will be wanting to get something done pretty quick!
 
Bass, It seems as if your dad healthcare is heading in the right direction. Be very careful during that intervening week between his long term care facility discharge and his first cardio appointment that his sodium intake is closly watched or he could end up right where he was again. I don't know what the root cause of your dad's mitral valve problem is but it may make a difference on his proposed care. There are many causes for mitral valve problems all the way from a result of a heart attack that affects the blood supply surrounding the valve area itself to numberous other causes as varied as mitral valve prolapse and rheumatic heart disease.

I'm assuming that your dad is elderly and his general condition will be taken into account as well as other co-existing heart problems. It is customary for a heart cath (including a right sided heart cath) to be done before a surgical plan is made. If he needs a valve replacement and doesn't also need any bypasses done they may do the replacement via an incision that doesn't need to open his sternum. It is commonly done now and particularily for the mitral valve. Although it is still major surgery it could make his recovery go a little quicker.

Please keep us updated on his condition and let us know how the consult goes.
 
Thanks for the reminder about the sodium Betty. He closely watches his salt intake & does not add salt to anything, but I told him he needs to tell mom to start buying "low sodium" canned goods when possible. I know most processed foods are loaded with sodium. I made sure he knows it now too!

Dad is 65 & the only other prexisting condition was CHF which the doc seems to think may be caused by his open mitral valve. I would not be surprised if they do find some other blockages or something. We are from the south & have always lived here where if it ain't fried, it wasn't properly cooked! LOL! We are trying really hard to get away from that thinking & getting better with it every day.
 
Dad is supposed to get released today. He is definately looking forward to getting home & sleeping in his own bed for a change. The doctor has given him strict orders about watching his diet & sodium intake. He even told him to watch the amount of fluids he takes in hoping we don't have a repeat of the fluid build-up before he can get into the cardio.
 
He may want to ask his PCP or Cardiologist about Compression Stockings.

They can help to minimize fluid retention in the lower legs.
 
He has some but has trouble wearing them because of some bad vonous stasis ulcers (or whatever they are called) on his lower legs. They are looking alot better & finally healing up nicely but still hurt him quite a bit.
 
We haven't decided for sure just yet...he goes to see the cardio on the 22nd. I think his name is Martin at Ark-La-Tex Cardiology. I guess we need to be figuring out what all we need to be asking him.

Bobbie, how are you feeling lately?
 
I am going to Dr Chihabra at Willis Knighten north. He seems to be a very good dr. He sent me in for a few tests on Mon which my other dr never did. I feel like I am in better hands now. Haven't gotten results back yet. I am doing pretty well. I have a few pains and things but could be stress. Hope to find out soon. Keep in touch and let me know about your dad
Bobbie
 
Well, dad had his first cardio appt today & they really seemed to like him. Said he actually took the time to explain lots of things & fully answer any questions.

The cardio feels like, according to the echo they did a few weeks ago, that he is definately a candidate for valve replacement & that it should solve most of his CHF, fluid retention, venous problems in his legs, etc. He is being scheduled for a TEE & a cath sometime pretty quick just to make sure it is as bad as the echo showed & make sure there are no other problems...he said the surgeons do not like to have any surprises once they get in there.

We also found out there are only 4 surgeons in Shreveport that do this type surgery. They do not see patients so I am not real sure how to go about checking them out or if we even really can.
 
We also found out there are only 4 surgeons in Shreveport that do this type surgery. They do not see patients so I am not real sure how to go about checking them out or if we even really can.[/QUOTE]

Internet bio? Others on the surgical team may meet with you?
 
Bass,

Did you get the Names of the Surgeons in your area?
Can you find their Office Telephone number?

I suggest calling their office Directly,
ask to speak with the Office Manager,
explain your father's situation,
and ask which Surgeon has the most experience
with Mitral Valve issues.

Getting to the right people directly
can save a LOT of Run-Arounds by 'intermediaries'!

Good Luck!

'AL Capshaw'
 
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